When is Cystolithotripsy Performed?

Cystolithotripsy is a procedure used to treat urinary bladder stones. It is indicated for almost all bladder stones except for extremely large ones, which may require alternative treatments.

What Sort of Preparation is Required?

On hospital admission, preoperative tests are typically conducted, including:

• Blood tests
• Chest X-ray
• Electrocardiogram (ECG)

If you are on anticoagulant medication, it may need to be stopped or replaced with injections under guidance from your cardiologist.

How is Cystolithotripsy Performed?

The procedure is performed under general or spinal anesthesia. The patient is positioned similarly to a gynecological exam. The steps include:

• Cleaning and lubricating the genital area and urethra
• Inserting a camera (cystoscope) via the urethra to locate the stones
• Using a lithotripter to crush and remove stones
• Placing a catheter at the end of the procedure

Continuous bladder irrigation may be needed in case of blood in the urine (hematuria). Hospital stay is usually about 2 days, and the catheter is removed once urine is clear, typically by the first postoperative day.

Types of Lithotripters Used

• Ballistic lithotripters (like a pneumatic hammer)
• Electrohydraulic lithotripters (underwater spark-gap discharge)
• Various types of laser lithotripters

Bladder stones often form due to urine stagnation caused by obstructions like benign prostate hyperplasia or urethral stricture. Cystolithotripsy is often combined with treatments for these conditions, such as TUR-P or optical urethrotomy.

What About After Cystolithotripsy?

• Burning sensation in the urethra
• Blood in the urine (may prolong catheter use or require irrigation)
• Bladder spasms and pain from catheter (relieved with medication)

Once the catheter is removed, an ultrasound is performed to check for residual urine in the bladder. Discharge instructions typically include:

• Antibiotic regimen
• Duration of physical activity restriction
• Importance of adequate fluid intake

What is the Effect of Cystolithotripsy on Quality of Life?

Most patients experience significant improvement and resume normal life after the procedure. However, recurrence is possible if the underlying cause of stone formation isn't treated. A specialist urologist should be consulted for ongoing evaluation.

Postoperative nutrition should include at least 1500ml of fluid intake daily and avoiding triggers like smoking, coffee, and alcohol that may irritate the bladder.